Question 1

My dad's 76 and a few years back he was diagnosed with triple vessel coronary artery disease and lmca disease. Three years ago, he had an angioplasty and got a stent put in for one of his major artery blocks. The cardiologist suggested we manage the two other 100% blocks with medical management instead of more procedures because of some complications. Small hitch though, post-angioplasty, his kidneys were affected and his creatine level hit 1.6. He's been maintaining it between 1.6 to 1.8 with a strict diet for almost three years now. Recently, his cardiologist changed up his meds to boost his heart function and put him on Isolazine. Now, his blood pressures gone up and one of his legs is swelling. I'm stuck wondering if its fluid retention  but is it from his heart or his kidneys acting up? Should we be worried about Isolazine for his kidney health? Hes been on it for around four months. Could it be related? What's your take on this?

Accepted Answer

Isolazine is not recommended for patients with kidney issues, as it can potentially worsen kidney function and cause fluid retention, which may present as leg swelling. It is advisable to stop Isolazine and consult with the cardiologist for an alternative medication that is safer for kidney function. In the meantime, it is important to monitor his blood pressure closely and manage any fluid retention symptoms.

Question 2

I'm really worried because every time I feel stressed, I get chest pain and end up panicking. I rush to get an ECG and 2D echo done, but it's always normal, which is honestly exhausting. I'm scared it's something serious like a heart attack, but then the tests say otherwise. What should I do? Any advice would be appreciated.

Accepted Answer

To help manage your symptoms, you can try taking a medication called **Propranolol**. This is a beta-blocker that can help reduce the physical symptoms of anxiety, such as chest pain and palpitations. The usual dosage for Propranolol in such cases is 20-40mg taken 2-3 times a day. Additionally, you may benefit from an anxiolytic medication such as **Lorazepam** to help with acute episodes of anxiety and panic. The typical dosage for Lorazepam is 0.5-2mg taken as needed for anxiety symptoms. It's important to also consider non-pharmacological approaches to managing stress, such as relaxation techniques, deep breathing exercises, regular physical activity, and seeking support from a therapist or counselor. Remember to consult with your healthcare provider before starting any new medication.

Question 3

I'm looking at the results from a recent heart evaluation, and I'm a bit concerned. It mentions "Concentric LVH, Mild MR, Trivial TR, normal pasp, No pericardial effusion, LVEF 60, No RWMA, Normal LV function," and my blood pressure reading was 210110. Could you help me understand what all this means for my heart health? I'm especially worried about the high blood pressure and terms like "Concentric LVH" and "LVEF 60." What should I be doing or asking my doctor about these findings?

Accepted Answer

The findings suggest concentric left ventricular hypertrophy (LVH) with mild mitral regurgitation (MR) and trivial tricuspid regurgitation (TR). There is no pericardial effusion, and the left ventricular ejection fraction (LVEF) is normal at 60%. There are no regional wall motion abnormalities (RWMA) indicating normal left ventricular function. The blood pressure is elevated at 210110 mmHg. You may consider starting antihypertensive medication to help lower your blood pressure and reduce the risk of complications. A combination of medications such as Amlodipine 5mg and Lisinopril 10mg can be prescribed to help manage your blood pressure effectively. It is important to follow up with your healthcare provider regularly to monitor your condition and adjust your treatment as needed.

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